Author Interviews, Heart Disease, NEJM, Vanderbilt / 18.09.2019
Fixed Dose Combination Polypill Can Reduce Barriers to Cardiovascular Care
MedicalResearch.com Interview with:
Daniel Muñoz, M.D, M.P.A
Assistant Professor of Medicine, Division of Cardiology
Medical Director for Quality, Vanderbilt Heart & Vascular Institute
Medical Director, Cardiovascular ICU
Vanderbilt University Medical Center
Nashville, Tennessee
MedicalResearch.com: What is the background for this study?
Response: Despite advances in the prevention and treatment of cardiovascular disease, it remains the number one global killer of both men and women. Patients face a variety of barriers to getting the care need, including cost and complexity of medication regimens. Innovative strategies are needed to improve the delivery of preventive care, especially when it comes to socio-economically vulnerable individuals. The polypill, a fixed-dose combination of 3 blood pressure lowering medications and a cholesterol lowering medication, may be a strategy for improving cardiovascular disease prevention.
We enrolled 303 patients at a community health center in Mobile, Alabama. Half of the patients were assigned to take a daily polypill, while the other half received their usual medical care. Participants underwent a standard medical exam, blood pressure measurement, and blood cholesterol testing during their initial visit, a 2-month visit, and a 12-month visit.
MedicalResearch.com: What are the main findings?
- Participants in the polypill group experienced a greater reduction in both systolic blood pressure and LDL cholesterol level, as compared with participants in the usual care group. These differences translate to an approximate 25% reduction in the risk of experiencing a cardiovascular event.
- At 12 months, adherence to the polypill regimen, as assessed based on pill counts, was 86%.
- The vast majority of our study participants were African-American (96%), with three quarters reporting an annual income below $15,000.